29 specialized coder jobs found

Job Description Job Description Job Posting: Medical Biller/Coder Clarius Medical Group PLLC – Sugar Land, TX (On-site)About Us Clarius Medical Group PLLC is a dynamic and patient-centered internal medicine and geriatrics practice. We aim to provide top-tier primary care across various settings including clinics, hospitals, and specialized facilities. Based in Sugar Land and extending our services throughout the Greater Houston area, we are committed to employing advanced EHR systems and interactive tools such as eClinicalWorks and Healow to enhance patient care and outcome measures. Position Summary We have an exciting opportunity for a Full-Time Medical Biller/Coder to join our administrative team. This position requires a professional who is well-versed in both front-end and back-end billing operations, applicable in outpatient or multi-site healthcare environments. The role involves close collaboration with healthcare providers, the practice management team, and external...

Job Number: 180041, Job Title: Risk Adjustment Coder II, Salary: $27.69 - $34.62 JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. JOB SPECIFICATIONS AND CORE COMPETENCIES Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions,...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition....

Description JOB SUMMARY: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. JOB RESPONSIBILITIES: • KEY RESPONSIBILITY 1: Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. o Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations. o Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate...

Key Responsibilities Conduct detailed audits of patient medical records to ensure clinical documentation supports quality care, medical necessity, and accurate billing practices. Identify documentation, coding, billing, and compliance discrepancies and develop corrective action recommendations. Prepare comprehensive audit reports and communicate findings to leadership and operational teams. Monitor compliance risks related to Medicare, Medicaid, and other federal healthcare programs. Provide consultative guidance regarding healthcare compliance regulations and best practices. Assist with responses to government audits, investigations, and regulatory inquiries. Review potential refund and repayment obligations related to federal healthcare programs. Support policy and procedure development based on regulatory updates and audit findings. Monitor changes in healthcare laws, regulations, and compliance requirements. Collaborate with clinical, revenue cycle,...

Overview Join our Team!!! Trustpoint Rehabilitation Hospital is a premier inpatient facility specializing in the treatment of stroke, brain and spinal cord injuries, orthopedic trauma, and other complex medical conditions. We are proud to be one of the few rehabilitation hospitals in the region that also provides care for pediatric patients, offering specialized services tailored to the unique needs of children and their families. Our mission is to provide compassionate, individualized care that empowers patients-of all ages-to regain independence and achieve their best outcomes. About Trustpoint Rehabilitation Hospital of Lubbock Located at 4302 Princeton Street in Lubbock, TX, Trustpoint is a 93-bed inpatient rehabilitation hospital specializing in adult and pediatric care. We are proud to be ranked in the Top 10% nationally for rehabilitative care and have earned The Joint Commission's Brain Injury, Stroke, and Spinal Cord Rehabilitation Certification. We are...

Overview Hospital Coder - Inpatient Rehabilitation - Ernest Health Ernest Health is a network of rehabilitation and long-term acute care hospitals. Ernest Health hospitals provide specialized medical and rehabilitative services to patients recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions. Our hospitals are located in Arizona, California, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah, Wisconsin, and Wyoming. CODER We're looking for professionals with a passion for coding, attention to detail, and with excellent communication skills. The Coder is an integral part of the hospital's team, working closely with Physicians and Director of Patient Outcomes (DPO). Successful candidates will enjoy working both independently and collaborating with a team of clinical professionals. Key responsibilities include: Provide expertise in the areas of coding and classification...

Overview Hospital Coder - Inpatient Rehabilitation - Ernest Health Ernest Health is a network of rehabilitation and long‑term acute care hospitals. Ernest Health hospitals provide specialized medical and rehabilitative services to patients recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions. Our hospitals are located in Arizona, California, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah, Wisconsin, and Wyoming. CODER We’re looking for professionals with a passion for coding, attention to detail, and with excellent communication skills. The Coder is an integral part of the hospital’s team, working closely with Physicians and Director of Patient Outcomes (DPO). Successful candidates will enjoy working both independently and collaborating with a team of clinical professionals. Key responsibilities Provide expertise in the areas of coding and classification systems to healthcare providers...

We are hiring a part-time Medical Coder to assign procedure and diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Responsibilities Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions. Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes. Perform related duties, as requested. Uphold the Organization's...

Become a part of our caring community The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Reviews medical records to report conditions that map to HCCs by reviewing medical record documentation and applying the appropriate ICD-10 diagnosis codes. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Works on projects that may include making phone calls to providers. Works within broad guidelines with...

Company Overview Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare...

Job Summary The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborate with multiple departments across the organization. Responsibilities Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk adjustment programs. Conduct thorough...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

Billing Coder IIIInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel...

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

Inpatient Coder III Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from...

Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect sensitive patient information Follow strict privacy and data security standards Clarify documentation with physicians when needed Collaborate with billing and administrative teams Regularly update knowledge of...

Certified Professional Coder Job Category: Finance and Accounting Requisition Number: BILLI035488 Posted: June 4, 2026 Full-Time On-site Odessa, TX 79761, USA Description Key Responsibilities: Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect...

ABOUT GREYSTAR Greystar is a leading, fully integrated global real estate platform offering expertise in property management, investment management, development, and construction services in institutional-quality rental housing. Headquartered in Charleston, South Carolina, Greystar manages and operates over $300 billion of real estate in more than 265 markets globally with offices throughout North America, Europe, South America, and the Asia-Pacific region. Greystar is the largest operator of apartments in the United States, managing over one million units/beds globally. Across its platforms, Greystar has nearly $79 billion of assets under management, including over $35 billion of development assets and over $36.5 billion of regulatory assets under management. Greystar was founded by Bob Faith in 1993 to become a provider of world-class service in the rental residential real estate business. To learn more, visit www.greystar.com. JOB DESCRIPTION SUMMARY This role oversees...

Description Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT. This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing...

Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities Abstract pertinent information from patient medical records. Assign appropriate...

Job Description Job Description Role Description This is a full-time on-site role for a Medical Billing Specialist. As a Medical Billing Specialist, you will play a crucial role in ensuring the financial health of our customers. We seek individuals with a strong work ethic, excellent problem-solving skills, and a genuine passion for medical billing. Your responsibilities will include managing insurance communications, reconciling insurance EOBs and payments, maintaining patient confidentiality, managing denials, utilizing ICD-10 codes, verifying insurance information, and working with commercial and government insurance providers. Due to the nature of the healthcare industry, a high degree of professionalism and attention to detail is essential.   Responsibilities Function as a subject matter expert in support of other billing team members. Demonstrate a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment...

Athra Systems / Crosstown Mental Health is a dynamic and forward-thinking organization dedicated to offering a wide array of behavioral health services and solutions. We pride ourselves on fostering a supportive and inclusive work environment where every team member can thrive and contribute to our collective success. Previously a private-pay company, we are now expanding to accept insurance to help more people, and the whole company is quickly adapting. Position Overview We are seeking a Medical Biller with comprehensive knowledge of behavioral health insurance billing. The Medical Biller will be responsible for the accurate and timely billing of all professional and facility services claims, ensuring all billing activities comply with applicable regulations. In this role, you will work closely with patients, insurance companies, and healthcare providers to resolve billing issues. If you have expertise in every step of the billing process, from intake to final payment, and are...